<style type="text/css" >
/*put your style here*/

.boeder1{

	 border-bottom: 2px solid rgb(200,200,200);
}
.boeder{

	 border-bottom: 1px solid rgb(200,200,200);
}
</style>

<script type="text/x-underscore-template">
//put your template here
</script>

<!-- header -->
<header class="bar-title">
    <a id="back" class="button back">
    <img src="../service/img/icon_back.ing" style="width:20px;">
    </a>
    <h1 class="title">家电报修详细</h1>
</header>

<!-- uncomment this if you want a sencondary-bars

<nav class="bar-standard bar-header-secondary">
</nav>

-->

<!-- content -->
<div class="content" >
	<div id="repairDetail">
<div style="width:100%;">

	<div style="padding:15px;font-size:20px;" class="boeder1">产品信息</div>
  <!-- <div class="" style="overflow: auto;position: absolute;width: 100%;left: 0"> -->
<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" >服务类型<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			 <div align="center" style="padding-right:15px;" class="sizenumber4 colortype3">
<input type="radio" checked="checked" name="day" value="terday" class="day" id="terday" /><label for="terday">报修</label>
<input type="radio" name="day" value="yesterday" class="day" id="yesterday"/><label for="yesterday">报装</label></div>
		</td>
	
	</tr>
</table>

	  
              
</div>

<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			
			<div  style="width:100px;" >产品类型<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			   <select name="" id="reason" style="width:80%;margin-bottom: 10px;">
				<option value="1">请选择</option>
				<option value="2">NEED CHANGE F/O</option>
				<option value="3">NEW CAP</option>
				<option value="4">CAP AND F/O CAN NOT TOGETHER</option>
				<option value="5">QUALITY OF CAP NOT ENOUGH</option>
				<option value="6">SPECIAL  REASON</option>
			</select>
				

		</td>
	
	</tr>

	<tr>
		
		<td style="width:35%;text-align:left;">
			

		</td>

		<td style="width:65%;">
			

			<select name="" id="reason" style="width:80%;margin-bottom:10px;">
				<option value="1">请选择</option>
				<option value="2">NEED CHANGE F/O</option>
				<option value="3">NEW CAP</option>
				<option value="4">CAP AND F/O CAN NOT TOGETHER</option>
				<option value="5">QUALITY OF CAP NOT ENOUGH</option>
				<option value="6">SPECIAL  REASON</option>
			</select>
		</td>
	</tr>
</table>

	  
              
</div>
<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:120px;word-break:break-all;" >要求服务日期<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			 <input data-showInit="true"
id="startTime" name="flightDate" style="width:40%;text-indent:0px;border-radius: 5px;" class="cube-datepicker saveDateClass" data-yearChangeable="true" data-monthChangeable="true" data-selectYearBefore="10" data-selectYearAfter="20" data-parentEl="body" readonly="readonly"/>
至
			 <input data-showInit="true"
id="startTime" name="flightDate" style="width:40%;text-indent:0px;border-radius: 5px;" class="cube-datepicker saveDateClass" data-yearChangeable="true" data-monthChangeable="true" data-selectYearBefore="10" data-selectYearAfter="20" data-parentEl="body" readonly="readonly"/>

		</td>
	
	</tr>


</table>

	  
              
</div>


<div style="padding:15px;">


			<div  style="width:120px;" id="submit2">要求服务描述<span style="color:red;">* </span></div>

			  <textarea name="" id="text" cols="30" rows="7" class="colortype6"></textarea>
	
	</tr>
</table>

	  
              
</div>


<div style="padding:15px;font-size:20px;"  class="boeder1">个人信息</div>




<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" id="submit2">用户姓名<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>

<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" id="submit2">邮箱</div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>


<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" id="submit2">手机号码<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>




<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">

			<div  style="width:100px;" id="submit2">其他电话</div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>
<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" >所在地区<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			 <select name="" id="reason" style="width:40%;margin-bottom: 0px;">
				<option value="1">山东</option>
				<option value="2">NEED CHANGE F/O</option>
				<option value="3">NEW CAP</option>
				<option value="4">CAP AND F/O CAN NOT TOGETHER</option>
				<option value="5">QUALITY OF CAP NOT ENOUGH</option>
				<option value="6">SPECIAL  REASON</option>
			</select><select name="" id="reason" style="width:40%;margin-bottom: 0px;">
				<option value="1">青岛</option>
				<option value="2">NEED CHANGE F/O</option>
				<option value="3">NEW CAP</option>
				<option value="4">CAP AND F/O CAN NOT TOGETHER</option>
				<option value="5">QUALITY OF CAP NOT ENOUGH</option>
				<option value="6">SPECIAL  REASON</option>
			</select>
<br>

		</td>
	
	</tr>

	<tr>
		

		<td style="width:35%;text-align:left;"></td>
		<td style="width:65%;"><select name="" id="reason" style="width:80%;margin-bottom: 0px;">
				<option value="1">地区</option>
				<option value="2">NEED CHANGE F/O</option>
				<option value="3">NEW CAP</option>
				<option value="4">CAP AND F/O CAN NOT TOGETHER</option>
				<option value="5">QUALITY OF CAP NOT ENOUGH</option>
				<option value="6">SPECIAL  REASON</option>
			</select></td>
	</tr>
</table>

	  
              
</div>
<div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" id="submit2">详细地址<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>



	  <div style="padding:15px;" class="boeder">


	<table style="width:100%;">
	
	<tr>
			<td style="width:35%;text-align:left;">
			<div  style="width:100px;" id="submit2">验证码<span style="color:red;">* </span></div>
		</td>
		<td style="width:65%;">
			   <input placeholder="" id="airNo" style="width:100%;text-indent:5px;
                  border-radius: 5px;padding:8px 5px 5px 5px"> 
		</td>
	
	</tr>
</table>

	  
              
</div>
              




<div style="padding:15px;text-align:center;">
	

	<div class="csair-btn-lite" style="width:100px;" id="submit">保存</div>&nbsp;&nbsp;&nbsp;<div class="csair-btn-lite" style="width:100px;background-color:gray;color:black;" id="submit">取消</div>
</div>

</div></div></div>